Healthcare Provider Details

I. General information

NPI: 1427213115
Provider Name (Legal Business Name): LISA J. ANDERSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA J. DONNER APRN

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 11/30/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 FAULKNER DR
LINCOLN NE
68516-4738
US

IV. Provider business mailing address

4545 R ST
LINCOLN NE
68503-3799
US

V. Phone/Fax

Practice location:
  • Phone: 402-858-4044
  • Fax: 402-858-4043
Mailing address:
  • Phone: 402-465-4545
  • Fax: 402-465-3621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110955
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number110955
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: